
<%@ include file="/commons/global.jsp"%>
<%@ page language="java" contentType="text/html; charset=UTF-8"
	pageEncoding="UTF-8"%>
<%@ include file="/commons/basejs.jsp"%>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html>
<head>
<title>报销实例表</title>
</head>
<body>
	<div>
		<form id="mainform" action="${path}/expInst/add" method="post">
			<table class="formTable">
				<tr>
					<td>报销实例编码：</td>
					<td><input type="text" name="expInstNo"
						class="easyui-validatebox" data-options="width: 150"
						value="${expInst.expInstNo}" /></td>
				</tr>
				<tr>
					<td>慢病证号：</td>
					<td><input type="text" name="illNo" class="easyui-validatebox"
						data-options="width: 150" value="${expInst.illNo}" /></td>
				</tr>
				<tr>
					<td>身份证号：</td>
					<td><input type="text" name="cardNo"
						class="easyui-validatebox" data-options="width: 150"
						value="${expInst.cardNo}" /></td>
				</tr>
				<tr>
					<td>总花费：</td>
					<td><input type="text" name="allCost"
						class="easyui-validatebox" data-options="width: 150,required:true"
						value="${expInst.allCost}" /></td>
				</tr>
				<tr>
					<td>报销金额：</td>
					<td><input type="text" name="bxPay" class="easyui-validatebox"
						data-options="width: 150,required:true" value="${expInst.bxPay}" />


					</td>
				</tr>
				<tr>
					<td>就诊时间：</td>
					<td><input type="text" name="treatTime" class="Wdate"
						placeholder="点击选择时间"
						onclick="WdatePicker({readOnly:true,dateFmt:'yyyy-MM-dd HH:mm:ss'})"
						readonly="readonly" data-options="width: 150,required:true"
						value="" /></td>
				</tr>
				<tr>
					<td>报销时间：</td>
					<td><input type="text" name="recodTime" class="Wdate"
						placeholder="点击选择时间"
						onclick="WdatePicker({readOnly:true,dateFmt:'yyyy-MM-dd HH:mm:ss'})"
						readonly="readonly" data-options="width: 150,required:true"
						value="" /></td>
				</tr>
				<tr>
					<td>发票编码：</td>
					<td><input type="text" name="treateinNo"
						class="easyui-validatebox" data-options="width: 150,required:true"
						value="${expInst.treateinNo}" /></td>
				</tr>
				<tr>
					<td>就诊机构：</td>
					<td><input type="text" name="treatAgenName"
						class="easyui-validatebox" data-options="width: 150,required:true"
						value="${expInst.treatAgenName}" /></td>
				</tr>
			</table>
		</form>
	</div>

	<script type="text/javascript">
		//添加修改区分

		$("input[name='expInstNo']").attr('readonly', 'readonly');
		$("input[name='expInstNo']").css('background', '#eee');
		$("input[name='illNo']").attr('readonly', 'readonly');
		$("input[name='illNo']").css('background', '#eee');
		$("input[name='cardNo']").attr('readonly', 'readonly');
		$("input[name='cardNo']").css('background', '#eee');
		$("input[name='bxPay']").attr('readonly', 'readonly');
		$("input[name='bxPay']").css('background', '#eee');
		$("input[name='treateinNo']").attr('readonly', 'readonly');
		$("input[name='treateinNo']").css('background', '#eee');
		//提交表单
		$('#mainform').form({
			onSubmit : function() {
				var isValid = $(this).form('validate');
				return isValid; // 返回false终止表单提交
			},
			success : function(data) {
				$.messager.confirm('确认', '报销成功！', function(r) {
					if (r) {
						if (d != null) {
							d.panel('close');
						}
					}
				});

			}
		});
	</script>
</body>
</html>